{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T15:01:44Z","timestamp":1784646104523,"version":"3.55.0"},"reference-count":57,"publisher":"Bioscientifica","issue":"3","license":[{"start":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T00:00:00Z","timestamp":1783036800000},"content-version":"vor","delay-in-days":72,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["journals.bioscientifica.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,6,1]]},"abstract":"<jats:p>Radioactive iodine therapy (RIT) is commonly used as an adjuvant treatment for differentiated thyroid cancer (DTC). While its efficacy is well established, this therapy can cause radiation-induced damage to the salivary and lacrimal glands due to their ability to concentrate iodine. These adverse effects may lead to xerostomia, sialadenitis, or xerophthalmia. The aim of this review and meta-analysis was to estimate the prevalence and characteristics of salivary and lacrimal dysfunctions in patients treated with RIT for DTC. Following PRISMA guidelines, a systematic search was conducted in PubMed and Scopus databases to identify studies published between 2000 and 2024. Meta-analyses of prevalence and odds ratios were carried out using random-effects models to estimate the pooled prevalence of events and the influence of administered activity. Thirty-eight studies were included in the review, of which sixteen were retained for the meta-analyses. The pooled prevalence of xerostomia decreased from 60% (95% CI: 0.28\u20130.85) at &amp;lt;2 months to 17% (95% CI: 0.10\u20130.28) at more than 1 year post-RIT. A significant association was observed between high levels \u2013 with study-specific thresholds \u2013 of administered I131 activity and the occurrence of xerostomia. Sialadenitis and lacrimal dysfunctions were also frequently reported. Despite heterogeneity in protocols and assessment tools, most studies highlighted a frequently persistent impairment in many patients. This systematic review and meta-analysis highlighted the frequency and persistence of salivary and lacrimal dysfunctions following RIT.<\/jats:p>","DOI":"10.1530\/etj-25-0402","type":"journal-article","created":{"date-parts":[[2026,4,22]],"date-time":"2026-04-22T17:05:42Z","timestamp":1776877542000},"update-policy":"https:\/\/doi.org\/10.1530\/crossmarkpolicy-17","source":"Crossref","is-referenced-by-count":0,"title":["Salivary and lacrimal disorders in patients treated with radioiodine for differentiated thyroid cancer"],"prefix":"10.1530","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-5922-1938","authenticated-orcid":true,"given":"Soline","family":"Bondet de La Bernardie","sequence":"first","affiliation":[{"name":"1"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marie-Odile","family":"Bernier","sequence":"additional","affiliation":[{"name":"1"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Camille","family":"Buffet","sequence":"additional","affiliation":[{"name":"2"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charlotte","family":"Lussey-Lepoutre","sequence":"additional","affiliation":[{"name":"3"},{"name":"4"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cl\u00e9mence","family":"Baudin","sequence":"additional","affiliation":[{"name":"1"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"416","published-online":{"date-parts":[[2026,4,22]]},"reference":[{"key":"2026072110071836100_bib1","volume":"1","author":"Defossez","year":"2019","journal-title":"Estimations Nationales De L\u2019Incidence Et De La Mortalit\u00e9 Par Cancer En France M\u00e9tropolitaine Entre 1990 Et 2018"},{"key":"2026072110071836100_bib2","first-page":"187","article-title":"Radioiodine ablation following thyroidectomy for differentiated thyroid cancer: literature review of utility, dose, and toxicity","volume":"6","author":"Andresen","year":"2017","journal-title":"Thyroid"},{"key":"2026072110071836100_bib3","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1089\/thy.2015.0020","article-title":"2015 American Thyroid Association Management Guidelines for adult patients with thyroid nodules and differentiated thyroid cancer: the American thyroid Association Guidelines task force on thyroid nodules and differentiated thyroid cancer","volume":"26","author":"Haugen","year":"2016","journal-title":"Thyroid"},{"key":"2026072110071836100_bib4","doi-asserted-by":"crossref","first-page":"1748","DOI":"10.1210\/jc.2014-3882","article-title":"Low-risk differentiated thyroid cancer and radioiodine remnant ablation: a systematic review of the literature","volume":"100","author":"Lamartina","year":"2015","journal-title":"J Clin Endocrinol Metab"},{"key":"2026072110071836100_bib5","doi-asserted-by":"crossref","first-page":"483","DOI":"10.1111\/cen.14950","article-title":"Radioiodine versus no radioiodine outcomes in low-risk differentiated thyroid cancers: a propensity-score matched analysis","volume":"99","author":"Satapathy","year":"2023","journal-title":"Clin Endocrinol"},{"key":"2026072110071836100_bib6","doi-asserted-by":"crossref","DOI":"10.3389\/fendo.2022.960265","article-title":"Prevention of salivary gland dysfunction in patients treated with radioiodine for differentiated thyroid cancer: a systematic review of randomized controlled trials","volume":"13","author":"Auttara-Atthakorn","year":"2022","journal-title":"Front Endocrinol"},{"key":"2026072110071836100_bib7","doi-asserted-by":"crossref","first-page":"557","DOI":"10.1007\/s11373-008-9253-z","article-title":"Biomarkers for human radiation exposure","volume":"15","author":"Chaudhry","year":"2008","journal-title":"J Biomed Sci"},{"key":"2026072110071836100_bib8","doi-asserted-by":"crossref","first-page":"770","DOI":"10.1016\/j.eprac.2024.04.017","article-title":"Eye-related adverse events after I-131 radioiodine therapy: a systematic review of the current literature","volume":"30","author":"Rahmanipour","year":"2024","journal-title":"Endocr Pract"},{"key":"2026072110071836100_bib9","doi-asserted-by":"crossref","first-page":"1646","DOI":"10.1089\/thy.2019.0563","article-title":"Radioiodine-induced salivary gland damage detected by ultrasonography in patients treated for papillary thyroid cancer: radioactive iodine activity and risk","volume":"30","author":"Horvath","year":"2020","journal-title":"Thyroid"},{"key":"2026072110071836100_bib10","doi-asserted-by":"crossref","first-page":"198","DOI":"10.1111\/odi.12774","article-title":"Radioactive iodine: an unappreciated threat to salivary gland function","volume":"24","author":"Sunavala-Dossabhoy","year":"2018","journal-title":"Oral Dis"},{"key":"2026072110071836100_bib11","doi-asserted-by":"crossref","first-page":"618","DOI":"10.2967\/jnumed.109.071449","article-title":"Influence of vitamin C on salivary absorbed dose of 131I in thyroid cancer patients: a prospective, randomized, single-blind, controlled trial","volume":"51","author":"Liu","year":"2010","journal-title":"J Nucl Med"},{"key":"2026072110071836100_bib12","doi-asserted-by":"crossref","DOI":"10.1155\/2016\/2586512","article-title":"Radioactive iodine administration is associated with persistent related symptoms in patients with differentiated thyroid cancer","volume":"2016","author":"Florenzano","year":"2016","journal-title":"Int J Endocrinol"},{"key":"2026072110071836100_bib13","doi-asserted-by":"crossref","first-page":"64","DOI":"10.35566\/jbds\/v3n2\/wang","article-title":"Conducting meta-analyses of proportions in R","volume":"3","author":"Wang","year":"2023","journal-title":"J Behav Data Sci"},{"key":"2026072110071836100_bib14","first-page":"3771","article-title":"Health-related quality of life of thyroid cancer patients undergoing radioiodine therapy: a cohort real-world study in a reference public cancer hospital in Brazil","volume":"28","author":"Ramim","year":"2020","journal-title":"Support Care Cancer"},{"key":"2026072110071836100_bib15","first-page":"1159","article-title":"Effect of radioiodine therapy under thyroid hormone withdrawal on health-related quality of life in patients with differentiated thyroid cancer","volume":"52","author":"Ming","year":"2022","journal-title":"Jpn J Clin Oncol"},{"key":"2026072110071836100_bib16","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1016\/j.surg.2019.01.034","article-title":"Clinical factors associated with worse quality-of-life scores in United States thyroid cancer survivors","volume":"166","author":"Goswami","year":"2019","journal-title":"Surgery"},{"key":"2026072110071836100_bib17","doi-asserted-by":"crossref","DOI":"10.1002\/pbc.26595","article-title":"Early and late adverse effects of radioiodine for pediatric differentiated thyroid cancer","volume":"64","author":"Albano","year":"2017","journal-title":"Pediatr Blood Cancer"},{"key":"2026072110071836100_bib18","doi-asserted-by":"crossref","first-page":"2381","DOI":"10.1002\/hed.24895","article-title":"Correlation among ocular surface disease, xerostomia, and nasal symptoms in patients with differentiated thyroid carcinoma subjected to radioiodine therapy: a prospective comparative study","volume":"39","author":"da Fonseca","year":"2017","journal-title":"Head Neck"},{"key":"2026072110071836100_bib19","doi-asserted-by":"crossref","first-page":"5319","DOI":"10.1007\/s00405-024-08761-3","article-title":"Subjective and objective effects of radioiodine therapy on the sense of smell","volume":"281","author":"Tabari","year":"2024","journal-title":"Eur Arch Otorhinolaryngol"},{"key":"2026072110071836100_bib20","doi-asserted-by":"crossref","first-page":"148","DOI":"10.1080\/00016357.2017.1399214","article-title":"Salivary evaluation in radioactive I131 treated patients with thyroid carcinoma","volume":"76","author":"Daniel","year":"2018","journal-title":"Acta Odontol Scand"},{"key":"2026072110071836100_bib21","doi-asserted-by":"crossref","first-page":"83","DOI":"10.1016\/j.clon.2006.11.005","article-title":"Salivary gland toxicity after radioiodine therapy for thyroid cancer","volume":"19","author":"Hyer","year":"2007","journal-title":"Clin Oncol"},{"key":"2026072110071836100_bib22","first-page":"ZC60","article-title":"Assessment of salivary gland function using salivary scintigraphy in pre and post radioactive iodine therapy in diagnosed thyroid carcinoma patients","volume":"10","author":"Badam","year":"2016","journal-title":"J Clin Diagn Res"},{"key":"2026072110071836100_bib23","doi-asserted-by":"crossref","first-page":"160","DOI":"10.3413\/Nukmed-0964-18-03","article-title":"Impact of sialendoscopy on improving health related quality of life in patients suffering from radioiodineinduced xerostomia","volume":"57","author":"Bulut","year":"2018","journal-title":"Nuklearmedizin"},{"key":"2026072110071836100_bib24","doi-asserted-by":"crossref","first-page":"1685","DOI":"10.2967\/jnumed.115.169888","article-title":"Effects of radioiodine treatment on salivary gland function in patients with differentiated thyroid carcinoma: a prospective study","volume":"57","author":"Klein Hesselink","year":"2016","journal-title":"J Nucl Med"},{"key":"2026072110071836100_bib25","doi-asserted-by":"crossref","first-page":"204","DOI":"10.1111\/eos.12689","article-title":"Scintigraphic evaluation of salivary gland function in thyroid cancer patients after radioiodine remnant ablation","volume":"128","author":"Kr\u010d\u00e1lov\u00e1","year":"2020","journal-title":"Eur J Oral Sci"},{"key":"2026072110071836100_bib26","doi-asserted-by":"crossref","first-page":"396","DOI":"10.1016\/j.clinimag.2014.12.018","article-title":"Salivary gland dysfunction after radioactive iodine (I-131) therapy in patients following total thyroidectomy: emphasis on radioactive iodine therapy dose","volume":"39","author":"Lee","year":"2015","journal-title":"Clin Imaging"},{"key":"2026072110071836100_bib27","first-page":"1100","article-title":"Dysfunction of the salivary and lacrimal glands after radioiodine therapy for thyroid cancer: results of the start study after 6-months of follow-up","volume":"33","author":"Baudin","year":"2023","journal-title":"Thyroid"},{"key":"2026072110071836100_bib28","doi-asserted-by":"crossref","first-page":"1964","DOI":"10.3174\/ajnr.A3063","article-title":"Assessment of salivary gland dysfunction after radioiodine therapy for thyroid carcinoma using non-contrast-enhanced CT: the significance of changes in volume and attenuation of the glands","volume":"33","author":"Nabaa","year":"2012","journal-title":"AJNR Am J Neuroradiol"},{"key":"2026072110071836100_bib29","first-page":"TC23","article-title":"A functional scoring system based on salivary gland scintigraphy for evaluating salivary gland dysfunction secondary to 131I therapy in patients with differentiated thyroid carcinoma","volume":"11","author":"Maruoka","year":"2017","journal-title":"J Clin Diagn Res"},{"key":"2026072110071836100_bib30","doi-asserted-by":"crossref","first-page":"1620","DOI":"10.2967\/jnumed.107.042192","article-title":"The dental safety profile of high-dose radioiodine therapy for thyroid cancer: long-term results of a longitudinal cohort study","volume":"48","author":"Walter","year":"2007","journal-title":"J Nucl Med"},{"key":"2026072110071836100_bib31","doi-asserted-by":"crossref","first-page":"462","DOI":"10.1016\/j.surg.2021.01.022","article-title":"Association between quality of life and patient-reported complications from surgery and radioiodine in early-stage thyroid cancer survivors: a matched-pair analysis","volume":"170","author":"Chow","year":"2021","journal-title":"Surgery"},{"key":"2026072110071836100_bib32","doi-asserted-by":"crossref","first-page":"666","DOI":"10.1016\/j.bjoms.2016.09.001","article-title":"Health-related quality of life, fear of recurrence, and emotional distress in patients treated for thyroid cancer","volume":"55","author":"Rogers","year":"2017","journal-title":"Br J Oral Maxillofac Surg"},{"key":"2026072110071836100_bib33","doi-asserted-by":"crossref","first-page":"2514","DOI":"10.1016\/j.ultrasmedbio.2021.05.013","article-title":"Progressive changes in the major salivary gland after radioiodine therapy for differentiated thyroid cancer: a single-center retrospective ultrasound cohort study","volume":"47","author":"Huang","year":"2021","journal-title":"Ultrasound Med Biol"},{"key":"2026072110071836100_bib34","first-page":"738","article-title":"Salivary and lacrimal gland dysfunction (sicca syndrome) after radioiodine therapy","volume":"42","author":"Solans","year":"2001","journal-title":"J Nucl Med"},{"key":"2026072110071836100_bib35","doi-asserted-by":"crossref","first-page":"1034","DOI":"10.1089\/thy.2016.0604","article-title":"Effect of thyroid-related symptoms on long-term quality of life in patients with differentiated thyroid carcinoma: a population-based study in Sweden","volume":"27","author":"Hedman","year":"2017","journal-title":"Thyroid"},{"key":"2026072110071836100_bib36","doi-asserted-by":"crossref","first-page":"609","DOI":"10.1089\/thy.2012.0106","article-title":"Salivary gland function 5 years after radioactive iodine ablation in patients with differentiated thyroid cancer: direct comparison of pre- and postablation scintigraphies and their relation to xerostomia symptoms","volume":"23","author":"Jeong","year":"2013","journal-title":"Thyroid"},{"key":"2026072110071836100_bib37","doi-asserted-by":"crossref","first-page":"172","DOI":"10.2967\/jnumed.118.212449","article-title":"Long-term effects of radioiodine treatment on salivary gland function in adult survivors of pediatric differentiated thyroid carcinoma","volume":"60","author":"Selvakumar","year":"2019","journal-title":"J Nucl Med"},{"key":"2026072110071836100_bib38","doi-asserted-by":"crossref","DOI":"10.3389\/fendo.2022.999331","article-title":"Health-related quality of life in long-term differentiated thyroid cancer survivors: a cross-sectional Tunisian-based study","volume":"13","author":"Missaoui","year":"2022","journal-title":"Front Endocrinol"},{"key":"2026072110071836100_bib39","doi-asserted-by":"crossref","first-page":"4085","DOI":"10.1210\/jc.2016-1605","article-title":"Risk factors of 131I-induced salivary gland damage in thyroid cancer patients","volume":"101","author":"Hollingsworth","year":"2016","journal-title":"J Clin Endocrinol Metab"},{"key":"2026072110071836100_bib40","doi-asserted-by":"crossref","first-page":"686","DOI":"10.1002\/hed.21520","article-title":"Late side effects of radioactive iodine on salivary gland function in patients with thyroid cancer","volume":"33","author":"Almeida","year":"2011","journal-title":"Head Neck"},{"key":"2026072110071836100_bib41","doi-asserted-by":"crossref","first-page":"746","DOI":"10.1177\/0194599813479777","article-title":"Salivary morbidity and quality of life following radioactive iodine for well-differentiated thyroid cancer","volume":"148","author":"Dingle","year":"2013","journal-title":"Otolaryngol Head Neck Surg"},{"key":"2026072110071836100_bib42","doi-asserted-by":"crossref","DOI":"10.20396\/bjos.v23i00.8673908","article-title":"Clinical manifestations of I-131 induced salivary gland dysfunction in patients with thyroid carcinoma","volume":"23","author":"Makarenko","year":"2024","journal-title":"Braz J Oral Sci"},{"key":"2026072110071836100_bib43","doi-asserted-by":"crossref","first-page":"767","DOI":"10.1097\/00003072-200211000-00003","article-title":"Scintigraphic evaluation of salivary gland dysfunction in patients with thyroid cancer after radioiodine treatment","volume":"27","author":"Caglar","year":"2002","journal-title":"Clin Nucl Med"},{"key":"2026072110071836100_bib44","doi-asserted-by":"crossref","first-page":"819","DOI":"10.1097\/MNM.0000000000000325","article-title":"Systematic evaluation of salivary gland damage following I-131 therapy in differentiated thyroid cancer patients by quantitative scintigraphy and clinical follow-up","volume":"36","author":"Wu","year":"2015","journal-title":"Nucl Med Commun"},{"key":"2026072110071836100_bib45","doi-asserted-by":"crossref","first-page":"342","DOI":"10.1001\/archoto.2009.16","article-title":"Clinical predictors of quality of life in patients with initial differentiated thyroid cancers","volume":"135","author":"Almeida","year":"2009","journal-title":"Arch Otolaryngol Head Neck Surg"},{"key":"2026072110071836100_bib46","doi-asserted-by":"crossref","first-page":"1605","DOI":"10.2967\/jnumed.108.061382","article-title":"Salivary gland side effects commonly develop several weeks after initial radioactive iodine ablation","volume":"50","author":"Grewal","year":"2009","journal-title":"J Nucl Med"},{"key":"2026072110071836100_bib47","doi-asserted-by":"crossref","first-page":"493","DOI":"10.1016\/j.endonu.2015.07.006","article-title":"Sialadenitis after radioiodine therapy. Analysis of factors that influence the response to medical treatment","volume":"62","author":"Geres","year":"2015","journal-title":"Endocrinol Nutr"},{"key":"2026072110071836100_bib48","doi-asserted-by":"crossref","first-page":"E227","DOI":"10.1002\/hed.23974","article-title":"Effect of recombinant human thyroid-stimulating hormone or levothyroxine withdrawal on salivary gland dysfunction after radioactive iodine administration for thyroid remnant ablation","volume":"38","author":"Iakovou","year":"2016","journal-title":"Head Neck"},{"key":"2026072110071836100_bib49","doi-asserted-by":"crossref","first-page":"3133","DOI":"10.1002\/hed.26359","article-title":"Salivary side effects after radioiodine treatment for differentiated papillary thyroid carcinoma: long-Term study","volume":"42","author":"Le Roux","year":"2020","journal-title":"Head Neck"},{"key":"2026072110071836100_bib50","doi-asserted-by":"crossref","first-page":"177","DOI":"10.3413\/Nukmed-0898-17-05","article-title":"Impact of age and sex on the quality of life following radioactive iodine ablation in patients with thyroid cancer","volume":"56","author":"Pak","year":"2017","journal-title":"Nuklearmedizin"},{"key":"2026072110071836100_bib51","doi-asserted-by":"crossref","first-page":"1663","DOI":"10.1056\/NEJMoa1108586","article-title":"Strategies of radioiodine ablation in patients with low-risk thyroid cancer","volume":"366","author":"Schlumberger","year":"2012","journal-title":"N Engl J Med"},{"key":"2026072110071836100_bib52","doi-asserted-by":"crossref","first-page":"1277","DOI":"10.6004\/jnccn.2010.0094","article-title":"Complications of radioactive iodine treatment of thyroid carcinoma","volume":"8","author":"Lee","year":"2010","journal-title":"J Natl Compr Canc Netw"},{"key":"2026072110071836100_bib53","first-page":"1551","article-title":"Intermediate and long-term side effects of high-dose radioiodine therapy for thyroid carcinoma","volume":"39","author":"Alexander","year":"1998","journal-title":"J Nucl Med"},{"key":"2026072110071836100_bib54","doi-asserted-by":"crossref","DOI":"10.1155\/2022\/7640405","article-title":"Quantitative scintigraphy evaluated the relationship between 131I therapy and salivary glands function in DTC patients: a retrospective analysis","volume":"2022","author":"Lv","year":"2022","journal-title":"J Healthc Eng"},{"key":"2026072110071836100_bib55","doi-asserted-by":"crossref","DOI":"10.1016\/j.oraloncology.2022.106280","article-title":"Effect of recombinant human thyroid stimulating hormone on long-term salivary gland dysfunction in thyroid cancer patients treated with radioactive iodine. A systematic review","volume":"136","author":"Sunavala-Dossabhoy","year":"2023","journal-title":"Oral Oncol"},{"key":"2026072110071836100_bib56","doi-asserted-by":"crossref","first-page":"1828","DOI":"10.4103\/IJO.IJO_2780_22","article-title":"Dependence of radioactive iodine-131 capture by the lacrimal ducts on the tear production level","volume":"71","author":"Yartsev","year":"2023","journal-title":"Indian J Ophthalmol"},{"key":"2026072110071836100_bib57","doi-asserted-by":"crossref","first-page":"483","DOI":"10.1089\/thy.2022.0095","article-title":"Impact of nasolacrimal dysfunction in thyroid cancer survivors","volume":"32","author":"Jonklaas","year":"2022","journal-title":"Thyroid"}],"container-title":["European Thyroid Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/etj.bioscientifica.com\/view\/journals\/etj\/15\/3\/ETJ-25-0402.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/etj.bioscientifica.com\/downloadpdf\/journals\/etj\/15\/3\/ETJ-25-0402.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/journals.bioscientifica.com\/etj\/article-pdf\/doi\/10.1530\/ETJ-25-0402\/520302\/etj-25-0402.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/journals.bioscientifica.com\/etj\/article-pdf\/doi\/10.1530\/ETJ-25-0402\/520302\/etj-25-0402.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T14:07:30Z","timestamp":1784642850000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.bioscientifica.com\/etj\/article\/15\/3\/ETJ250402\/77628\/Salivary-and-lacrimal-disorders-in-patients"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,22]]},"references-count":57,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2026,6,1]]}},"URL":"https:\/\/doi.org\/10.1530\/etj-25-0402","relation":{},"ISSN":["2235-0802","2235-0640"],"issn-type":[{"value":"2235-0802","type":"electronic"},{"value":"2235-0640","type":"print"}],"subject":[],"published":{"date-parts":[[2026,4,22]]},"article-number":"ETJ250402"}}